EHS-COVID (513) Disruptions in maternal health service use during the COVID-19 pandemic

15 January, 2022

In September 2021 we discussed a paper on 'Disruptions in maternal and child health service utilization during COVID-19: analysis from eight sub-Saharan African countries'.

This new paper looks specifically at maternal health services in 37 LMICs. I have invited the authors to join us.

CITATION: Aranda Z, Binde T, Tashman K on behalf of the Cross-site COVID-19 Syndromic Surveillance Working Group, et al. Disruptions in maternal health service use during the COVID-19 pandemic in 2020: experiences from 37 health facilities in low-income and middle-income countries. BMJ Global Health 2022;7:e007247.

Correspondence to Zeus Aranda;


The COVID-19 pandemic has heterogeneously affected use of basic health services worldwide, with disruptions in some countries beginning in the early stages of the emergency in March 2020. These disruptions have occurred on both the supply and demand sides of healthcare, and have often been related to resource shortages to provide care and lower patient turnout associated with mobility restrictions and fear of contracting COVID-19 at facilities. In this paper, we assess the impact of the COVID-19 pandemic on the use of maternal health services using a time series modelling approach developed to monitor health service use during the pandemic using routinely collected health information systems data. We focus on data from 37 non-governmental organisation-supported health facilities in Haiti, Lesotho, Liberia, Malawi, Mexico and Sierra Leone. Overall, our analyses indicate significant declines in first antenatal care visits in Haiti (18% drop) and Sierra Leone (32% drop) and facility-based deliveries in all countries except Malawi from March to December 2020. Different strategies were adopted to maintain continuity of maternal health services, including communication campaigns, continuity of community health worker services, human resource capacity building to ensure compliance with international and national guidelines for front-line health workers, adapting spaces for safe distancing and ensuring the availability of personal protective equipment. We employ a local lens, providing prepandemic context and reporting results and strategies by country, to highlight the importance of developing context-specific interventions to design effective mitigation strategies.

Best wishes, Neil

Neil Pakenham-Walsh, HIFA Coordinator,